Partners in crime: Diabetes and obesity

The number of Americans with type 2 diabetes has almost doubled in the past decade, to an estimated 24 million. That includes the one in four who don’t even know they have the disease. And some experts believe it won't be long before that number exceeds 30 million.

Why the explosion? Obesity. Up to a third of us are now clinically obese. And since the vast majority of people with type 2 diabetes are also overweight, it's no wonder those two disorders are often referred to as twin epidemics. Indeed, three out of four respondents to a Consumer Reports survey of 5,012 people with type 2 diabetes said they were overweight. And overweight respondents were more than twice as likely to say that they were unsuccessful at managing their diabetes.

The good news is that efforts to rein in excess weight can help prevent and control the condition. For example, a three-year study published in the New England Journal of Medicine showed that for people at high risk for type 2 diabetes, a 7 percent weight loss through diet and 30 minutes of exercise, five days per week, resulted in a 58 percent drop in the expected incidence of the disease. And our survey found that efforts to control weight, by improving diet and increasing activity, were effective strategies for helping people successfully manage their diabetes. Diabetes educators and dietitians were rated as being more helpful than primary-care physicians and endocrinologists in educating patients about nutrition.

The bottom line: The solution to tackling obesity and diabetes is simple. You can't choose your parents, but there are no barriers to eating right and exercising.

—Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser

What your walking speed can tell your doctor

Doctors are trained fortune-tellers of sorts. But instead of divining the future through tea leaves or Tarot cards, they look to our bodies for clues. If our blood pressure is high, they may warn of heart and circulation problems that could be down the road. Ditto for high cholesterol. But doctors can also draw upon subtler signs — even, for example, our walking speed.

As odd as it may sound, studies show that healthy older adults who walk slowly are at higher risk of falls, disabilities, frequent hospital visits, and other health problems. And, according to a new study, slow walkers also have triple the chance of dying from heart disease, although the reasons aren't yet clear.

The study included 3,208 seniors ages 65 to 85 in France. Each person's walking speed was clocked over 6 meters (almost 20 feet). The researchers then checked on the participants every couple of years. All were in reasonably good health at the start of the study, and didn't have any conditions that could have substantially affected how fast they walked, such as Parkinson disease, dementia, or a disabling stroke.

After five years, 209 people had died, including 99 from cancer, 59 from heart disease, and 51 from other causes (such as infections and respiratory failure). The researchers found that the slowest walkers were three times more likely to have died of heart disease than those who walked at a faster clip. However, they didn't find a link between slow walking and other causes of death, including cancer.

Q&A: Can you get diabetes from eating too much sugar?

While continually overdosing on sweets can help trigger diabetes in someone with prediabetes or another predisposition, it is not a direct cause of it (although the sweet stuff can make you pack on pounds, a major risk factor). People with type 2 diabetes gradually develop resistance to insulin, the hormone responsible for helping to convert blood sugar into energy, and diabetes develops when the pancreas can no longer keep up with the increased demand. In the less common type 1 form, the body's immune system attacks insulin-producing cells in the pancreas.

Q&A: Can poor sleeping habits increase diabetes risk?

Yes. Research presented at a June 2009 conference backed by the American Academy of Sleep Medicine suggests that sleeping for five or fewer hours a night significantly increases a person's risk of type 2 diabetes. And a 2008 study found that depriving healthy young adults of deep sleep disrupted their bodies' ability to regulate blood sugar. In addition, recent research suggests that type 2 diabetes may be associated with a genetic mutation that affects the sleep-inducing hormone melatonin.

Sugar Wars: Industry front group defends high fructose corn syrup

Big Corn is fighting it out with the Big Apple in ad wars. Last year, the Corn Refiners Association launched a series of ads defending the processed sweetener against its attackers. This year, The New York Department of Health and Mental Hygiene launched ads asking subway riders if they were "pouring on the pounds." The posters depict a bottle of soda, sports drink, or sweetened ice tea morphing into blobs of fat as it’s poured into a glass. Now, the deceptively named Center for Consumer Freedom is getting in on the food fight.

The group—which according to SourceWatch was founded with tobacco industry funding and has been financed in the past by sweetened-beverage companies, including Coca-Cola, among other major food industry players—launched it’s own poster in New York asking "Big Apple or Big Brother?" Now the group has launched a million dollar ad campaign defending high fructose corn syrup.

The SweetScam campaign includes this ad, which depicts a sugar cube, a honey bear, and an ear of corn in a police line-up for causing weight gain. The "victim" isn’t sure which culprit is to blame, but thinks it might be the corn because he’s "seen that high fructose corn syrup guy on the news." The police officer informs him they all have the same calories, and are "processed by the body the same way too." He releases the sticky suspects after determining that the victim is "making this stuff up without any proof."

The point is summed up as "a sugar is a sugar." To a certain extent that’s true—and most Americans would do well to consume less of all of them. According to the U.S. Department of Agriculture, the average American should consume no more than about 40 grams (approximately 10 teaspoons) of added sugars a day–added sugars don’t include those that occur naturally in fruit and other foods. But the average American consumes more than twice that amount about 22 teaspoons per day, and adolescent boys between 14 and 18 consume more than three times more, about 34 teaspoons per day.

FDA says diabetes drug Byetta poses kidney risks

People with diabetes may want to use extra caution with the drug exenatide (Byetta). The Food and Drug Administration Monday added a warning about the risk of potentially life-threatening kidney problems to the package insert of the injectable diabetes drug.

The FDA said that from April 2005 through October 2008 it received 78 reports of kidney function problems, including 62 cases of kidney failure and four deaths, in people taking Byetta. The drug can cause nausea, vomiting, and diarrhea, and these might have contributed to the kidney problems, the FDA said.

Lifestyle changes can stave off diabetes long term

What works best to stave off diabetes type 2 in people at high risk? New long-term research shows there’s really no substitute for good old-fashioned healthy diet and plenty of exercise.

More than 23 million Americans have diabetes, and the numbers are rising. The condition is linked to being overweight and not getting enough exercise, although that’s not always the cause. There have been a number of studies looking at whether diabetes medication or other interventions help prevent or delay a diabetes diagnosis for people who are overweight and at high risk.

Perhaps surprisingly, one of the biggest of these studies showed that getting support and advice about exercising more, eating healthfully, and losing weight was more successful than taking a diabetes medication called metformin. Now, follow-up studies have shown the effects last for at least 10 years.

During the follow-up, people who’d taken metformin and those who had been on a pretend (placebo) medication were also given advice about diet and exercise. Perhaps as a result, their chances of getting diabetes then fell. So, the gap between the groups narrowed during the 10 years, but overall, people who’d started with the diet and exercise program were less likely to have diabetes by the end of the study.

Live amid green to stay in the pink

I live in the Emerald City (aka Seattle), where parks and other green spaces are as plentiful as Starbucks (on second thought, is anything as plentiful as Starbucks?). But in our neighborhood, you don't see nearly as much green, and we actually have to bundle the kids into the car if we want to take a stroll through a park. This lack of local green space is certainly an inconvenience. But a new study suggests it might also be a health risk.

Having few green areas nearby may actually increase the risk of depression and other health problems, the study reports. The researchers pulled data from the health records of nearly 350,000 people across the Netherlands, and tracked how often patients were diagnosed with 24 different disease types. They then mapped how much green space was in the patients' neighborhoods by using postal codes and land-use data.

Overall, they found that people living within 1 kilometer (six-tenths of a mile) of more extensive green space had lower rates of 15 out of the 24 disease types, including asthma and other breathing problems, diabetes, severe intestinal complaints, and neck and back problems. But the link was strongest for depression and anxiety. For example, depression affected 32 in 1,000 people in areas with only 10 percent green space. But this dropped to 24 in 1,000 people in areas with 90 percent green space.

Children and people with low levels of education and income seemed especially likely to benefit from having more green space nearby. This may be because both groups tend to spend more time close to home.
The study didn't explore why living near ample green space might improve a person's health outlook, but several factors may be at work, including better air quality, and more outdoor spaces for relaxation, socializing, and exercise.

7 creative ways to beat vegetable boredom

Green beans. Spinach. Peas. Green beans. Spinach. Peas. We all know that vegetables are a staple of a healthful diet, but getting them on your plate everyday can be a challenge—and eating the same ones day-in and day-out can be downright boring. We don’t always have the time, know-how, or budget to perk up a simple salad or side of broccoli. And it’s hurting us. According to a recent report by the Centers for Disease Control and Prevention, fruit and vegetable consumption is down. Only 27 percent of Americans get the recommended 3 or more servings of vegetables per day.

A diet rich in colorful vegetables can help you live longer and fight heart disease, stroke, some types of cancer, and type 2 diabetes. Vegetables can keep you looking your best, too. Vitamin A in carrots, spinach, sweet potatoes, red peppers, winter squash, kale, and collard greens can help keep eyes and skin healthy, and protect against infections.

Our staff came up with some creative ways to beat veggie boredom. Here are seven of my favorites—one for everyday of the week:

• Off to a good start. Make a Spanish omelette for breakfast, with onions, peppers, tomatoes, mushrooms, and asparagus—or any other vegetable you have on hand. Half a cup of chopped vegetables equals one serving.

• For stew lovers. A good pressure cooker is a must-have. Throw in squash, carrots, celery, parsnips, lentils—you name it, and you can create your very own one-of-a-kind meals. One staffer is fond of his Israeli couscous and one-pot chicken-and-rice dish.

• Add some crunch. Serve risotto or mashed potatoes with romaine leaves. Try wrapping the potatoes in the lettuce leaf to add texture and color to your starch of choice. Or mix arugula or spinach into the potatoes.

Diabetes drugs Januvia, Janumet may pose dangerous risk

The Food and Drug Administration today warned that two diabetes medicines--sitagliptin (Januvia) and sitagliptin/metformin (Janumet) have been associated with dangerous cases of swelling of the pancreas.

The FDA notified healthcare professionals and also changed the drugs’ labeling (package insert) to reflect the pancreas risk. The pancreas aids in digestion and also in regulating blood sugar levels. The agency said it had received reports of 88 cases of acute pancreatitis between October 2006 and February 2009, including many cases that were severe enough to require hospitalization and four people that were admitted to the intensive care unit. The FDA recommends that healthcare professionals monitor patients carefully for this problem in patients taking either Januvia or Janumet.

In our Best Buy Drug report on diabetes drugs, we recommend against Januvia and advise instead that people with diabetes first try generic metformin. Januvia has not been shown to be any more effective than generic metformin at keeping your blood sugar levels under control and it is also significantly more expensive. To read more about diabetes drugs, check out our free Best Buy Drugs report.

--Steve Mitchell, associate editor

Should sugar-sweetened beverages be taxed?

Not many people want to entertain the thought of new taxes during tough economic times (in truth, many of us don't like the idea in the best of times either). But a group of public health experts make a persuasive case for one in a recent issue of the New England Journal of Medicine.

They recommend putting a tax on sodas, energy drinks, and other beverages with added sugar (diet drinks would be exempt). They argue that such a tax would help curtail Americans' consumption of sugar-sweetened drinks, while raising funds to promote good nutrition, and help cover health costs related to regularly imbibing these beverages.

Americans' demand for sugary drinks has doubled in the last 30 years, and recent studies have linked consumption of these calorie-infused beverages to a higher risk of obesity, diabetes, and heart disease— conditions that exact a huge toll on individuals, families, and the health care system overall. Medical costs associated with being overweight or obese alone are estimated at $147 billion (9.1 percent of total U.S. health care expenditures), with Medicare and Medicaid picking up half of this tab. These are complex public health issues with many causes and no easy solutions. But might taxing sugary drinks help?

Thin people can’t get type 2 diabetes, and other myths

When I was 12, my well-meaning uncle told me I could "catch diabetes" from eating too much candy. Of course, his advice was likely a scare tactic to help me tame my overactive sweet tooth. I later found out that while loading up on sweets is not a direct cause of diabetes, sugary foods can trigger the condition in someone with prediabetes.

Type 2 diabetes is a complicated and often deceptive disease—and popular misconceptions can make it tricky for a person to be diagnosed and effectively manage their condition. Public-health officials estimate that of the 24 million Americans with type 2 diabetes, and nearly one-quarter are unaware they have the disease. Our recent diabetes survey also revealed confusion when it came to listing risk factors, symptoms, and complications related to type 2 diabetes.

One such risk factor, obesity, brings us to another big diabetes myth: You have to be overweight to develop diabetes, and thin people can’t get the disease. While there’s no doubt that obesity is a major contributor to type 2 diabetes, genetics also play a role. Blood sugar levels can increase even in thin people and our experts recommend that people aged 45 and older have their blood sugar checked every three years.

Do you think you might have diabetes? Get to know your blood sugar

Recently a close friend told me she suspected she had type 2 diabetes. My first thought was, "No you don’t! You’re too young and healthy to be diabetic." I was hoping her concerns were a misguided attempt to self-diagnose her constant tiredness. After finally seeing her doctor, she found out she wasn’t diabetic, but definitely needed some rest. Her diabetes scare got me thinking about how much I really know about diabetes. Very little. And, it turns out, I’m not alone—many Americans don’t know much about diabetes, according to a new Consumer Reports National Research Center survey. Overall, the survey found that people were more than twice as likely to know their blood pressure as their blood sugar level.

Based on gender, my friend might have had an advantage over men in getting preventative care and treatment for diabetes. According to the survey, women are more likely to report they talk with a doctor about vital health statistics for blood pressure, blood sugar, and cholesterol. Still, both genders revealed confusion when it came to recognizing the risk factors, symptoms, and complications related to type 2 diabetes.

Want fewer medical bills? Try out these healthy habits

As the saying goes, an ounce of prevention is worth a pound of cure. And in these recessionary times, it can mean big savings on exorbitant medical interventions. A recent study by researchers at the Johns Hopkins Bloomberg School of Public Health found that promoting good health in children under age 5 could save up to $65 billion in future health-care costs.

For starters, eating right and exercising in your day-to-day life can help prevent illness. For example, if you have high cholesterol, changing your diet and working out more can reduce your risk of stroke and heart attack, and the need for years of costly cholesterol drugs.

While each medical condition likely has its own specific lifestyle changes that can help, here are some healthy habits you can benefit from:

• Eat colorful produce. Rich, varied colors are best. They indicate that you're getting a range of phytochemicals, which may help fight disease.

• Get movin’. The benefits of exercise are endless. It can reduce the risk of heart disease and certain cancers. Aerobic exercise can improve LDL (bad) and HDL (good) cholesterol levels, reduce blood pressure, lower your risk of type 2 diabetes, help you lose weight, and ease stress and depression. See our tips on getting started and being safe.

Quick ways to de-stress for free

Losing a job can lead to health problems, including high blood pressure, diabetes, heart disease, heart attack and stroke, reports USA Today on research by on research by a Robert Wood Johnson Foundation Health and Society scholar. The report showed that even when workers found new jobs, they still had an increased risk of new stress-related health problems.

No surprises there. Stress is to blame for numerous health problems, including heart attack, stroke, depression, sleeplessness, and alcohol abuse. And with joblessness on the rise, it’s likely that stress-related health problems will follow suit.

Don’t ignore the warning signs—and if stress is making you sick, try these coping strategies:

• Don’t just sit there—take a 20-minute walk, do some yard work, or go dancing. People who get regular aerobic exercise have lower stress-hormone levels, and their heart rate and blood pressure stay steadier when they're under duress. Physical activity can also boost your mood, relieve tension, and provide a therapeutic time-out.

• Find a hobby that helps you relax. This could include listening to mellow music, reading a good book, going for a stroll, repeating a prayer, or writing. Whichever approach you take, find some time each day to unwind.